| NPI | 1316312648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 46723) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 0014996) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2015-12-11 |